Article

The prevalence of neuromuscular scoliosis in children with spinal
cord injury (SCI) is high. Published reports suggest that age at time of injury
is the most important determinant. No studies have evaluated neurological
characteristics using standardized methods to determine if they are strong
predictors of scoliosis. OBJECTIVE: To test the hypothesis that neurological
level, motor score, and injury severity are strong predictors of neuromuscular
scoliosis. METHODS: Two hundred seventeen children were evaluated using the
testing guidelines of the International Standards for Neurological Classification
of Spinal Cord Injury. Cobb angles were calculated from plain radiographs as a
measure of scoliosis. Multivariate analysis with statistical selection was used
to determine predictors of worst Cobb angle and spinal fusion. The odds of having
a spine fusion for subjects with at least 2-year follow-up and injured prior to
(n=16) and after (n=91) 12 years of age were calculated. RESULTS: The hypothesis
was not supported. Although there was a very high prevalence (100%) of scoliosis
in the study sample, age at time of injury was the only predictor of worst curve
(P < .0001) and spine fusion (P < .007). The calculated odds ratio demonstrated
that children injured <12 years were 3.7 times more likely to have a spine fusion
(95% CI, 0.31-44.64). CONCLUSION: There is a very high prevalence of
neuromuscular scoliosis in pediatric SCI. Neurological level, motor level, and
severity of injury are not strong predictors. Age is the only predictor of worst
curve and spine fusion.

Langue : ANGLAIS